Fitting CLEAR440

Transcription

Fitting CLEAR440

Fitting CLEAR440
Introduction to this manual
The WIDEX CLEAR™440 hearing aid is fitted using Compass V5.0 or later versions. In this
manual you will find all relevant information regarding fitting CLEAR440 and DEX and
using the new tools available with Compass 5.0 and later.
The manual is divided into chapters, each describing areas important for fitting
CLEAR440 – wireless options, fine-tuning options, new program options, additional options and changes in the rationale behind the fitting.
In each chapter different functionalities are described with reference to their audiological
and technical background as well as their performance and usage.
Seven supplementary quick guides have also been produced for quick reference to vital
CLEAR440 and DEX fitting procedures.
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Introduction
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The following section provides an overview of
the various chapters in this manual.
Chapter 1: CLEAR440 – wireless options – Page 4
In this chapter, the use of wireless fitting without fitting cables is described in detail, introducing the
nEARcom as well as the USB Link option. This chapter also focuses on the audiological background of
the new InterEar features available with CLEAR440, describing the concept of the InterEar Speech Enhancer, InterEar TruSound Compression and several other InterEar features.
With CLEAR440 a range of DEX accessories is also available, and this chapter describes the functionality and fitting procedure for the different DEX accessories.
Chapter 2: CLEAR440 – New fine-tuning options – Page 13
Hearing aid fine tuning is dependent on the hearing aid user’s experience with the hearing aids in various listening situations. With CLEAR440, a range of new fine-tuning tools is available for the hearing
care professional. To achieve the optimum opportunities when fine tuning gain, a 15 channel gain settings panel is introduced. New options are also available when working with acclimatisation and the
new audiological features in CLEAR440.
Chapter 3: New program options with CLEAR440 – Page 24
CLEAR440 offers a range of new program options, ensuring a wider choice for the hearing care professional when working to secure optimal use of CLEAR440 hearing aids in all listening situations. With
InterEar Zen, new options are available when fine-tuning a Zen program.
Chapter 4: Additional options when fitting CLEAR440 – Page 31
To support the hearing care professional in the fine-tuning session, the Solution guide has been refined
with CLEAR440. Fitting CLEAR440 binaurally will offer the client a range of InterEar functionalities,
and two CLEAR440 hearing aids fitted together will automatically include these options. Some clients
are originally only fitted monaurally, but will later want to start using binaurally fitted hearing aids. The
process of establishing a pair of CLEAR440 hearing aids is supported by Compass to make it easy and
intuitive to the hearing care professional.
Other options mentioned in this chapter are the Service Reminder and how to protect the fitting using
a safety code in Compass.
Chapter 5: Rationale changes affecting the fitting – Page 37
Assessment of in-situ acoustics (AISA) is a concept used in the fitting of Widex hearing aids to ensure
fitting precision. AISA is continuously developed, and the final chapter explains the reasoning behind
AISA III. More information on AISA can be found in WidexPress 24.
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overview
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Chapter 1:
CLEAR440 – wireless options
Wireless fitting
Fitting CLEAR440 hearing aids is as simple and
easy as fitting any other Widex hearing aid. The
illustrative and intuitive Compass software will
guide the hearing care professional throughout
the fitting procedure as well as subsequent finetuning sessions and counselling.
Like for all other Widex hearing aids, performing five basic fitting steps will ensure an optimum fitting for every client:
• Pre-fitting considerations based on client info
and possibly individual data measurements
like in-situ RECD
• Performing the Sensogram
• Performing the feedback test
• Setting hearing aid options according to client
wishes and needs
• Administer post fitting counselling and possible fine tuning
Without the need for cables and connecting
adaptors, CLEAR440 can be fitted using only a
wireless connection established with the appropriate hardware - the nEARcom.
When using the nEARcom hardware, other hearing aid products from both Widex and
other manufacturers can be fitted using cables
connected directly to the nEARcom.
With CLEAR440 the practical
implications of fitting the client have been drastically improved. Introducing Wireless
fitting, the hearing care professional no longer has to concern themselves with
the physical cable connection between the fitting software and the hearing aids. This connection is now established wirelessly to the benefit
of both the hearing care professional and the
client.
Wireless fitting
• Hassle-free fitting method for both the hearing care professional and
the client.
• A choice between involving the client in the initial detection procedure
and performing the procedure without involving the client.
• Wireless fitting with industry standard hardware – the nEARcom which also supports fitting with cables.
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Wireless detection
All CLEAR440 and more recent hearing aids
with wireless technology from Widex are always
fitted wirelessly using the WidexLink technology to establish the connection to the hearing
aids.
With the fitting software (Compass V5 or a later
version) the hearing care professional is guided
through the important steps of detecting the
hearing aids chosen for the client and establishing the connection for both the right and left
hearing aid.
It is also recommended that the hearing care
professional colour-mark BTE hearing aids to
identify left and right. You are now ready to
perform the detection procedure in Compass.
Detection procedure
To detect the hearing aids in Compass, the hearing care professional has to place the nEARcom
either on a table or around the client’s neck. The
Detection guide describes both methods.
This can be done by the hearing care professional before the client’s visit or together with
the client as the first thing in the fitting session.
Each hearing care professional will have their
own preferences as to which method to use,
but may also base the decision on information
about their client.
• Involving the client in the detection procedure
can be an advantage when the client is able to
co-operate. When hearing the sound to identify the hearing aid, the client must indicate
whether the hearing aid is left or right.
• Performing the detection procedure before
meeting the client can be an advantage when
the client is not able to co-operate, for example if they are hard of hearing or the client is
a child.
Performing a wireless
fitting
Performing a wireless fitting requires Compass
V5, hearing aids with wireless technology from
Widex and the nEARcom with a Widex Tech
Module.
To get it right from the start with wireless fitting
you connect NOAHlink to the nEARcom and
choose the nEARcom as Interface in the Setup
menu in Compass.
Fig. 1: The detection procedure with the nEARcom on a
table.
When the hearing aids have been placed in the
middle of the neck loop or on the client’s ear,
the hearing care professional is ready to start
the detection procedure. Please follow the quick
guide and learn how easy this procedure is.
When the hearing aids are detected and identified, the hearing care professional can proceed
with the fitting process in Compass as usual.
Detect hearing aids as follows:
1. To identify hearing aids, make sure they are
placed in the middle of the nEARcom neck
loop and then use the Play buttons under
Identify HA. When you select a Play button,
the relevant hearing aid plays a sound for 6
seconds and in some models a light-emitting
diode lights up.
2. While this is happening, remove the hearing
aid from the nEARcom and listen to it.
3. In Compass, select whether the hearing aid is
for the left or right ear.
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4. Repeat the procedure if you are fitting two
hearing aids.
5. Click Next to connect the hearing aids.
6. Select a starting point and make sure the
acoustic identity is correct.
7. Position the hearing aids in the client’s ears
and the nEARcom around the neck of the
client.
USB Link
With the new WidexLink wireless technology,
Widex also introduces a new hardware concept
in fitting – the Widex USB Link.
Using the Widex USB Link enables fitting of
CLEAR440 hearing aids using an intuitive and
easy hardware solution without the need for
NOAHlink. The Widex USB Link has a standard
USB plug and connects directly to the fitting
computer.
For those hearing care professionals who are
not familiar with the use of NOAHlink as fitting
interface, the Widex USB Link is an easy alternative when fitting Widex wireless hearing aids.
Fig. 2: The detection procedure with the Widex USB
Link.
The detection procedure is the same as with the
nEARcom. The hearing care professional just
has to choose the Widex USB Link as interface
in the Setup menu in Compass.
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CLEAR440 - designed to
coordinate and synchronise
InterEar TruSound compression Coordination of compression
Coordinated
Right
Left
Right
ILD = normal
Normal
Left
Right
ILD = normal
Due to the accurate and very frequent data
transmission between two CLEAR440 hearing aids, important cues for preserving a more
natural perception of the environment are supported. This includes the coordination of compression and speech enhancement, as well as
volume and program synchronisation.
Level at eardrum
WidexLink – accurate and frequent data
transmission
Left
It is well known that one of the major difficulties
for people with hearing loss is to determine the
direction of a sound source. Using two hearing
aids fitted in a balanced matter has up till now
been the preferred suggestion on how to eliminate this problem. The C-ISP platform supporting the CLEAR440 hearing aids supports the
coordination and synchronisation of important
features relevant for precisely this task.
ILD ≠ normal
By coordinating the compressors of two
CLEAR440 hearing aids the important Interaural Level Difference (ILD) is preserved. The
ILD is used by the brain to place sound sources
correctly in the horizontal plane. The Interaural
Level Difference arises because of the shadow
effect of the human ear. For a normal hearing
listener, the level of a sound reaching the right
ear will be higher at the right eardrum than at
the left eardrum because of the head shadow
effect. Coordinating the compressors of two
hearing aids with InterEar TruSound compression allows the normal ILD to be maintained.
Uncoordinated
Fig. 3: Displaying the ILD without hearing aids (normal),
with uncoordinated hearing aids and with coordinated
hearing aids.
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InterEar Speech Enhancer
Supporting coordinated sound processing
The Speech Enhancer in CLEAR440 is continuously coordinated to support the hearing impaired client’s ability to direct focus to a speaker speaking from the side of the listener. This
could be of great importance in a noisy environment. See Fig. 4.
Maintaining coordinated sound processing between two hearing aids in real life situations is
one of the main scopes of CLEAR440 hearing
aids. But inappropriate use of the volume control and program shift can interfere with this
coordination. CLEAR440 therefore introduces Volume Sync and Program Sync to support
the coordination of sound processing. A pair of
CLEAR440 hearing aids fitted with coordinating features will this way continue to work as
intended, also in daily life. Changing volume on
one hearing aid means same volume change on
the other hearing aid. Changing program on one
hearing aid means also changing program on
the other hearing aid.
When working as a coordinated feature, the
Speech Enhancer will have access to knowledge
on the location of the dominant speaker, allowing it to activate a fast acting gain mechanism
that supplies extra gain in speech important frequency areas to support best possible speech
intelligibility.
In a CLEAR440 fitting, the coordination of compression and speech enhancement is a default
feature setting for best possible utilisation of
the wireless possibilities of CLEAR440.
Further possibilities with WidexLink
With the accurate and frequent data transmission obtained with WidexLink, coordination of
other CLEAR440 features is also an option. Using an extra set of data, a pair of CLEAR440
hearing aids are able to determine the presence
of feedback and take action to actively cancel a
feedback signal. When fitting CLEAR440 hearing aids, this coordination is enabled by default
to manage feedback as efficiently as possible.
Fig. 4: The InterEar Speech Enhancer works as a coordinated feature and supports the ability to
direct focus to the dominant speaker.
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InterEar Zen
For clients using the Zen feature WidexLink
offers a unique possibility of distributing the
Zen tones over two hearing aids. In a pair of
CLEAR440 hearing aids, each Zen style will by
default be chosen to be the same on both hearing aids and the tones in each individual style
will be distributed over the two hearing aids to
create a stereo-like effect.
the user by means of the SmartSpeak message
“Partner Check”. Simultaneously a LED in the
two hearing aids will start flashing1.
The lost partner alarm can be activated under
Acoustic indicators in the HA configuration window under Finalise.
Adjusting InterEar functionalities
The InterEar functionalities are by default enabled in binaural fittings. If needed, the functionalities can be disabled in the InterEar configuration panel. See Fig. 5.
Some of the InterEar functionalities are linked
to each other. If you disable Program selection,
please be aware that Compression, Noise reduction, Feedback cancelling, and Zen are disabled
too.
The InterEar partner monitor
CLEAR440 features the InterEar partner monitor – allowing a lost partner alarm to be activated whenever the connection between two
CLEAR440 hearing aids is lost. If the user loses
his hearing aid, for instance on the golf course,
the InterEar partner monitor that surveys the
coupling between the two hearing aids will alert
The hearing care professional can activate the
Lost partner function under Acoustic indicators.
Please notice that the InterEar icons in the Fine
tuning window do not indicate whether the
functionalities are activated or not. See Fig. 6
Fig. 5: The InterEar functionalities are found under Finalise and HA configuration.
Fig. 6: The InterEar icons indicate the association between the InterEar functionalities and the feature.
1
In C4-PA, C4-m, C4-m-CB and C4-FS
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DEX accessories
With CLEAR440, a new product concept from
Widex is introduced – the DEX.
calls, ending calls and controlling volume and
programs, a TV-DEX for the TV situation - transmitting sound EchoFree™ in the bandwidth from
100 Hz to 11 kHz2 and in stereo. Furthermore the
RC-DEX is introduced – a compact dedicated
remote control with access to program toggle
and volume control.
DEX – reflecting user requirements
The DEX products are designed to meet two
fundamental user requirements:
• Ease of use
• High sound quality
RC-DEX: compact remote control
TV-DEX: for TV-viewing
M-DEX: for mobile phone use and
advanced remote control
For people with hearing loss, situations like
watching TV, talking in a mobile phone or listening to sound from, for instance, the computer can be difficult despite appropriately fitted
hearing aids, and many therefore choose to use
assistive listening devices.
With assistive listening devices like teleloop systems or other systems able to transmit audio
from an external sound source and into hearing
aids, the importance of sound quality must not
be overlooked. Sound quality will be reflected
not only in the bandwidth of the transmitted
signal but also in whether or not the signal is
transmitted in stereo and if the signal transmission is delayed compared to a direct signal.
Teleloop systems are bandwidth restricted to
approximately 5 kHz and sound is transmitted
in mono. For other transmitting systems based
on digital wireless transmission, bandwidth varies and the signal is most often transmitted in
mono. Furthermore, many of such systems introduce a delay to the transmitted signal resulting in reduced sound quality, for example hollow sound or echoes.
The main purpose of the DEX products is to
make the user interface easy and intuitive – by
minimising confusion and time on the learning
curve. An aim is that the DEX devices should react in a manner that is predictable as well as understandable for the user.
RC-DEX
Due to its compact and small size, the RC-DEX
is easy to carry in a pocket. Young people or
people in active employment may find the RCDEX discreet to use.
The RC-DEX is a user-friendly remote control for
adjusting volume or changing programs. The
keys are easy to manipulate, making allowance
for users with reduced dexterity.
With DEX Widex introduces a product concept
targeted at specific situations. An M-DEX for
mobile phone use; with options for receiving
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Model dependent
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TV-DEX
The M-DEX
To offer the user a superb sound quality, the
infra-red light and telecoil are now replaced by
the TV-DEX. The TV-DEX caters for users who
are dependent on assistive listening devices and
‘just’ want to watch TV without any effort. The
high sound quality may appeal to the critical
hearing aid user.
For those users who enjoy music, the M-DEX allows input from personal audio devices like MP3
players.
The TV-DEX is built for enjoying TV and audio.
This DEX device aims to answer hearing aid users’ complaints of not being able to hear the TV
- and their nearest relations’ complaints of the
TV being too loud.
The TV-DEX Controller features a Room Off
key, which mutes the hearing aid microphones.
Room Off allows the hearing aid user to shut off
any disturbing sounds in the room while enjoying TV or audio.
When Room Off is not activated, the audio signal is still transmitted directly to the hearing
aids. At the same time the hearing aid microphones are activated allowing the user to follow a conversation while listening to the audio
signal. Widex EchoFree technology makes sure
that the user does not experience delays, distortion or echoes while the audio is being transmitted and the hearing aid microphone is activated.
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The M-DEX offers users connectivity between
their hearing aids and mobile phones.
This device aims to meet the challenge of talking in mobile phones with personal hearing
aids by transmitting the signal from the mobile
phone directly to the hearing aids. The Room
Off function allows the user to focus on the telephone conversation without being disturbed
by surrounding sounds picked up by the hearing
aid microphones.
M-DEX also goes a convenient step further for
users of Widex hearing aids with the FreeFocus
feature. FreeFocus allows users to hear in selected directions, such as passengers behind
them when driving. M-DEX lets users choose
right/left/front/rear focus to optimise speech
intelligibility in situations where the user is unable to turn towards the speaker.
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Matching DEX
In the Matching status window, the hearing care
professional chooses which DEX devices he
wishes to match. It is possible to see an animation of the matching procedure. The matching
procedure begins when you click Start matching
and you just have to follow the matching wizard.
See Fig. 7.
Changing the volume control step size
It is possible to set the volume control to smaller
or larger increments via the RC-DEX as well as
the M-DEX. This is done in the HA configuration
window in Compass. Please see ‘Definable volume control’ below.
Fig. 7: The DEX matching tool is found under Finalise in the left menu in Compass.
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Chapter 2:
CLEAR440 – New fine-tuning options
15 channel gain settings
matrix
Fine tuning CLEAR440 – new tools for the
hearing care professional
A major part of a successful hearing aid fitting is the possibility of meeting client wishes in the fine-tuning session. Several generations of Widex high end products have featured
sound processing in 15 channels and the ability
to measure Sensogram in expanded mode to
reflect the hearing threshold in more discrete
frequencies. This has formed the basis for very
precise hearing aid fittings and client satisfaction. Fine-tuning multi channel hearing aids is
a matter of being able to influence the performance of the sound processing with respect to
both input level and frequency while also taking
into account client background in terms of hearing aid usage in the past.
The competent hearing care professional performs fine tuning based on the client’s wishes
but also on their professional knowledge as to
how features such as acclimatisation will influence client satisfaction, how adaptive features
influence the sound processing of the hearing
aid as well as knowledge on how counselling the
client will affect fine-tuning wishes.
Fig. 8: Basic gain settings panel – four channels.
For these basic channels, fine tuning is possible
for soft, normal and loud input levels. Together with the parameters of Loudness master and
gain settings for loud sounds and soft sounds,
the default gain settings panel meets the needs
of many fine-tuning situations in the clinic.
Some clients have specific fine-tuning needs not
met by the default gain settings panel. In such
cases performing the expanded Sensogram will
allow Compass detailed information about the
hearing threshold. In the fine-tuning session the
hearing care professional will now have access
to fine-tuning gain discretely in 15 channels.
Compass features a new expanded gain settings
panel for setting gain in 15 discrete channels
and adjusting overall loudness.
Fine-tuning gain settings in CLEAR440
For the situations where fine tuning is warranted and necessary, the hearing care professional needs a set of tools that will allow him to fine
tune gain for specific input levels and frequency
regions as well as adjust feature settings, acclimatisation and other program specific options.
Fig. 9: Expanded gain settings panel – 15 channels.
By default, Widex high end hearing aids can be
fine-tuned in four basic channels; 500, 1000,
2000 and 4000 Hz. Fine-tuning gain in these
anchor channels means that gain in neighbouring channels will also be adjusted by interpolation and extrapolation.
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Options with the 15 channel
gain settings panel
Discrete fine tuning of gain
The expanded Sensogram has long been an option in Compass ensuring even more precision in
the fitting of Widex hearing aids. In some cases
complaints regarding the initial fitting can be
resolved just by performing an expanded Sensogram and allowing this to be the basis for the
fitting.
With the ability to fine-tune gain discretely in 15
channels, special fine-tuning needs can be met
complementing the performance of the expanded Sensogram.
The expanded Sensogram below shows that
the hearing threshold drops at 6 kHz. Therefore,
more gain is introduced specifically in this channel as seen in the gain settings panel. The hearing care professional has the option of further
fine-tuning the gain specifically in this channel.
Fig. 10: Hearing threshold drops at 6 kHz and as a result,
the gain for this channel is higher.
When gain is adjusted using the 15 channel gain
settings panel, the adjustment will influence this
channel only, allowing very specific gain adjustments to be made.
Using the gain settings panel in Compass:
• The hearing care professional can choose
between a basic gain settings panel with
four channels and an expanded with 15
channels.
• Fine-tuning gain in the basic panel will
allow for interpolation to neighbouring
channels.
Fig. 11: Displays how gain can be adjusted in one single
channel without influencing neighbouring channels.
• Fine-tuning gain in the expanded panel allows for specific fine tuning in one channel
only.
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Allowing the hearing care professional to see
how basic gain changes affect neighbouring
channels
When using the basic gain settings panel with
four channels, changes in gain in one of the four
channels will influence neighbouring channels
because of interpolation. This is reflected in the
15 channel panel and allows the hearing care
professional to see how the gain changes affect
neighbouring channels. see Fig. 12.
Other options
Target gain
Target gain for the specific channel can be
viewed using the Target icon. Targets are displayed for the specific program.
Fig. 13: Target gain shown in white numbers.
In both the basic and expanded panel it is possible
to adjust one or more channels and input levels simultaneously. A new “Select all”
function is available for adjusting the overall loudness. The function substitutes the previous “loudness master” function.
Undo/redo
Compass V5.1 introduces an undo/redo option.
With this option the adjustments made in the
gain settings panel can be undone. With the
first adjustments in the panel the undo button
will be active. And if an adjustment is undone,
the redo button will become active.
The 15 channel gain settings panel is complemented by the well known gain adjustment for
soft sound and loud sounds.
Fig. 14: Undo and redo functions in the gain settings
panel.
Fig. 12: Changes in gain made in the 4 channel matrix will be reflected in the 15 channel
matrix because of extrapolation/interpolation.
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The expanded gain settings
panel in relation to the
ClearBand handle
Acclimatisation in CLEAR440
With the 15 channel gain settings panel, gain in
the uppermost channels can be adjusted separately for both specific frequency regions and
input levels. This gives the hearing care professional more opportunities when fine-tuning the
very high frequencies in a ClearBand model.
When working with a ClearBand model, the
ClearBand tool
is still available, allowing the
hearing care professional direct and quick control of the ClearBand range in terms of simultaneous adjustment of level for input in these high
frequencies.
Fig. 15: The ClearBand tool is available in a ClearBand
model.
The options in the 15 channel gain settings panel
make it possible to adjust gain in discrete channels as well as for specific inputs.
Fig. 16: Adjusting gain for specific frequency regions and
input levels in the three upper channels in the hearing
aid.
The need for specific fine tuning of, for instance,
gain settings is best established after the client has gone through an acclimatisation period. New hearing aid users often need to have
gain settings for input and frequency levels
that reflect their limited amount of experience
with amplification. However, also experienced
hearing aid users shifting from one hearing aid
brand to another may find it difficult to tolerate
the target gain for their hearing loss. For that
reason, many hearing care professionals work
with acclimatisation options in their fitting –
either establishing an acclimatisation program
or, if this is not an option, fine-tuning a master
program to support the best possible acclimatisation. Widex high-end hearing aids have up
till now offered the choice of an acclimatisation
program with reduced gain in regard to frequency as well as input level.
With CLEAR440 the option to work with acclimatisation is further enhanced. With the introduction of a global acclimatisation strategy, the
hearing care professional can choose to let acclimatisation be the basis for all listening programs. The acclimatisation strategy chosen still
reflects gain adjustments in regard to both frequency and input level.
The Acclimatisation tool
The Acclimatisation tool found in the Gain settings panel in the Fine tuning window will adjust
gain specifically for frequency and input levels
to meet the acclimatisation requirements of, for
instance, new users. The tool is by default ac-
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tive only in the master program, reflecting the
fact that adjustment of acclimatisation level will
influence all programs in the hearing aid. See
Fig. 17.
For specific handling of acclimatisation in a specific program such as a music program, this
program must first be unlinked from the master program. The ability to unlink programs and
work specifically with the acclimatisation level
in a single program also helps the hearing care
professional to create a specific acclimatisation
program; a copy of the master program can be
created and unlinked for specific adjustment of
the acclimatisation level. See Fig. 18.
An acclimatisation level can be active for Master
as well as for Music, TV, Comfort and Reverse
focus. If you are working with compound programs, an acclimatisation level can be set individually for the part of the compound program
with an acclimatisation level option.
Acclimatisation options in CLEAR440:
• The acclimatisation handle will apply acclimatisation globally across all programs.
• The acclimatisation handle can be accessed in individual programs by using the
unlink function.
• A specific acclimatisation program can be
created in an unlinked master2 program.
Fig. 17: Active acclimatisation handle in the master program.
Fig. 18: Using the unlink function to activate the acclimatisation handle in other programs than master.
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Applying acclimatisation
The acclimatisation handle shows that level 4
is the fully acclimatised fitting with prescribed
gain for all input levels and frequencies. Choosing one of the lower acclimatisation levels results in an adjustment of gain for specific input
levels and frequency areas. Gain is adjusted the
most for the highest frequencies, a little less for
mid frequencies and least for low frequencies.
Soft sounds are the input levels most affected
when choosing acclimatisation, normal sounds
are less affected and loud sounds are only affected to a small degree.
New sound processing
features in CLEAR440
warrant new fine-tuning
handles
Fine-tuning ISP hearing aids has always included the option to work with microphone
as well as speech and noise modes and feedback settings. This, of course, reflects the sound
processing features found in ISP hearing aids.
CLEAR440 features new advanced sound
processing features and consequently new finetuning options.
The HD Locator
The HD Locator with Speech tracer found in ISP
hearing aids provides a unique possibility of locating speech in noisy surroundings while maintaining audibility for soft sounds in quiet surroundings. The HD Locator works as an adaptive
feature continuously adapting its workings to
the surrounding environment. Maintaining a
good signal-to-noise ratio in noisy surroundings
while preserving audibility in quiet settings is
the main target for the HD Locator.
It is well known that using BTE hearing aids has
a negative effect on the ability to locate sounds
coming directly from the front or back. Hearing
aid users are often reported to confuse these
two sound directions.
Fig. 19: Gain for the three different acclimatisation levels.
Target gain is displayed in white.
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Sitting in a library trying to ascertain from
which direction a sound is coming from can
be difficult for users of BTE style hearing aids.
Although audibility is preserved with the HD
Locator with Speech tracer, the direction of
a sound can still be hard to determine. This
makes it difficult to direct the necessary degree of focus to the sound source. A teacher in a quiet classroom trying to deduce from
where a request for help is coming could be
another example. The reason for this difficulty
is to be found in the implications of wearing a
BTE hearing aid. The outer ear (pinna) helps a
normal-hearing individual to localise a sound
source in space. The shadowing effect of the
pinna is most pronounced in the area from 2-5
kHz with an attenuation of approximately 3-4
dB for sounds coming from behind.
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Front-back diff [dB]
10
Utilising the matched microphone system of
CLEAR440, the HD Locator now features a
Digital Pinna mimicking the pinna effect of a
normal-hearing listener. The electronic pinna
characteristic found in the HD Locator secures
optimal front/back localisation opportunities in
quiet surroundings, while still allowing for the
other main task of the HD Locator, namely to
support the best possible signal-to-noise ratio
in noisy surroundings.
Speech and noise modes
The Speech Enhancer has an InterEar functionality in a CLEAR440 fitting. With the WidexLink
technology, two CLEAR440 hearing aids can
exchange data. For the InterEar speech Enhancer this means that focus is directed towards the
most dominant speaker in a noisy environment
with more speakers. The InterEar functionality
can be disabled using the InterEar configuration
tool in HA configuration.
5
-0
-5
-10
-15
500
1k
2k
4k
Frequency [Hz]
Average
Fig. 20: The Pinna effect: The average shadow effect of
the pinna. Sounds coming from behind are attenuated
by 3-4 dB relative to sounds from the front.
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The TruSound Softener – Impulse noise modes
Sudden sharp noises like the chink of porcelain or slamming doors present a specific challenge in hearing aid sound processing. Because
of the abrupt and short lasting nature of these
sounds, they may disturb and annoy the hearing aid user. Handling short and abrupt sounds
warrants a specific mechanism able to detect
such sounds and take immediate action. With
CLEAR440 sound processing is enhanced with
such a mechanism - The TruSound Softener. See
Fig. 21.
Feedback cancelling modes
The Feedback cancelling mode options are
SuperGain, SuperGain Max and SuperGain Music. The InterEar feedback system in CLEAR440
hearing aids enables the transmission of data
on possible feedback between the two hearing
aids. This allows for a more precise decision on
whether or not there is feedback in the hearing
aid in question. The feedback cancelling mode
is still a choice between Super Gain (default),
Super Gain Max and Super Gain Music.
The InterEar functionality of the feedback cancelling system can be disabled using the InterEar configuration tool in HA configuration.
!
Filter bank
Regular
(slow)
Fast
compression compression
Input
signal
Output
signal
Ultra-fast
compression
Transient detection
Transient handling
Fig. 21: Principle of the TruSound Softener.
20 CLEAR440 – New fine-tuning options
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Choosing different modes
in Feature settings
The speech and noise modes and the feedback cancelling modes have an InterEar functionality – indicated by the InterEar icon on
the screen. This icon indicates that the feature
can work with InterEar functionality regardless of whether the InterEar coordination is
turned on or off in the fitting. In a monaural
fitting, this icon will still indicate the ability of
this feature to be InterEar in binaural fittings.
See Fig. 22.
Microphone modes
In a default fitting, the microphone mode
chosen is HD locator with Digital Pinna in
most listening programs. The HD Locator features, as an inherent component, the Speech
tracer and now also the Digital Pinna supporting the ability to tell whether sounds are coming from the front or back.
HD Locator omni and HD Locator dir are mainly
for demonstration purposes, although HD Locator omni is the default setting for the music
program. They both reflect a fixed setting of
the microphones, supporting either a full omni
mode that does not support a good signal-tonoise ratio, or a fixed directional system which
compared to HD Locator will support a poorer signal-to-noise ratio when speech originates
from behind the user.
The HD Locator omni with Digital Pinna is a
choice for the user who is often in a quiet environment where he has to locate sudden sounds
– for instance a librarian. It is not chosen as the
default setting by any program, but could be
used when creating a listening program for such
a user.
HD Locator with Digital Pinna – supports localisation in quiet environments (classroom,
library) and ensures best possible signal-tonoise ratio in noise.
HD Locator - supports full audibility in quiet and optimal signal-to-noise ratio in noise
– useful when full audibility is necessary in
quiet.
Fig. 23: The different options in Microphone modes.
There are five different microphone modes;
the two adaptive modes are HD Locator with
or without Digital Pinna, and the three fixed
modes are HD Locator omni with or without
Digital Pinna and HD Locator dir.
HD Locator omni with Digital Pinna - supports permanent ability to localise sound in
quiet (in a quiet environment like a library)
HD Locator omni - primarily used for demonstration purposes. Used as the default setting in the music program.
HD Locator dir - primarily used for demonstration purposes.
Fig. 22: Feature settings displaying the ability for speech and noise modes and feedback cancelling
modes to have an InterEar functionality.
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21
Speech and noise modes
Impulse sound modes
Fig. 25: The different options in Impulse sound modes.
Fig. 24: The different options in Speech and noise
modes.
The Speech and noise modes menu lets you
choose between the SIS based noise reduction
or the SII based Speech Enhancer, the Speech
Enhancer being the default choice for the master program. The Speech Enhancer has the ability to work with InterEar functionality.
The Speech Enhancer has InterEar functionality and is based on the Speech Intelligibility Index (SII) for best possible speech intelligibility.
The noise reduction modes – the Speech
Intensification System (SIS) – ensure good
quality noise reduction when speech intelligibility is not the main purpose.
22 CLEAR440 – New fine-tuning options
With CLEAR440, the Impulse sound modes
are introduced. The TruSound Softener detects
and handles impulse sounds for the comfort of
the user. It is active by default in the fitting. In
a comfort program the TruSound Softener Plus
on mode is active to provide a higher degree of
dampening of impulse sounds. This setting can
also be chosen for the master program for clients who are extra sensitive to impulse sounds.
For the music program, the default setting of
the TruSound Softener is off - since music will
include impulse sounds that should not necessarily be dampened by the hearing aid.
The TruSound Softener detects and handles
impulse sounds.
By default on in all acoustic programs except for the music program.
TruSound Softener Plus on can be chosen
for extra sound sensitive clients.
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Feedback cancelling modes
Fig. 26: The different options in Feedback cancelling
modes.
The Feedback cancelling modes menu allows
you to choose between different feedback cancelling options. Different programs will display
different default feedback cancelling modes.
For example, the music program features SuperGain music as default mode since this mode
is especially designed for listening to music.
The feedback cancelling modes have InterEar functionality allowing for a more
precise decision on feedback occurrence.
SuperGain allows as much gain possible
without feedback.
SuperGain max will allow extra gain, introducing a higher risk of feedback.
SuperGain music is designed specifically
for listening to music in a stable environment.
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Fine-tuning Feature settings
The default feature settings in a CLEAR440 fitting reflect the general perspective and vision
with the CLEAR440 aids: to allow InterEar coordination and synchronisation of relevant hearing aid features to support the perception of
natural sound. During fine tuning, the hearing
care professional can, of course, choose to offer
the client other feature settings than the default
settings proposed by Compass, for instance by
choosing Classic noise reduction modes or other Locator settings etc.
Also the feature settings can be changed independently for each ear by disabling Binaural adjust. We do not recommend to choose different
feature settings in a binaural fitting since this
might undermine the intentions of the coordinated features in a CLEAR440 fitting.
Choosing two different speech and noise modes
like Speech Enhancer and Noise reduction, for
example, will counteract the intentions of the
InterEar Speech Enhancer working to preserve
the client’s ability to focus on a dominant speaker.
Binaural adjust can be disabled for monaural adjustment of left and right hearing aid
individually.
Disabling Binaural adjust may affect the intentions of the InterEar functionality in the
fitting.
23
Chapter 3:
New program options with CLEAR440
New programs offering a
solution to more listening
situations
Using hearing aids with multiple programs will
always include the risk of the user getting out
of sync with the program choices. Trying to balance the sound on two hearing aids that by error operates in two different programs will, of
course, be difficult. Clients will experience a disturbed and out of balance sound picture. Sometimes, the user may want to use different program settings on the two hearing aids – think
of the client watching TV with his wife, only
switching one hearing aid to Tele and leaving
the other in the Master program for better perception of the surroundings.
CLEAR440 features a range of new possibilities
in meeting client wishes in terms of special listening programs. With the development of the
WidexLink technology used in CLEAR440, program handling is synchronised to give the client
easier control over program selection. Using the
program button on one hearing aid or a dedicated remote control – RC-DEX or M-DEX – the
default program handling setting will permit the
user to change programs in both hearing aids at
the same time. Together with the SmartSpeak
or SmartTone features, this further helps eliminate the confusion some hearing aid users experience when handling their hearing aids.
24 New program options with CLEAR440
New programs
For those situations where clients need to have
different settings of the hearing aid programs
– like the TV situation mentioned earlier, or if
the client wants to have Zen in one hearing aid
and Master in the other while concentrating on
a task at work, CLEAR440 features a range of
compound programs. These compound programs were developed to reflect the most frequent usage of un-synchronised programs in
hearing aids.
When compound programs
are activated by the client, the
InterEar functionality of compression and noise reduction
is not active. The IE Feedback
cancelling will still be active reflecting the fact that the Inter
Ear exchange of data relevant
to assess the origin of a feedback like signal is still relevant. Also the InterEar
volume and program control will still be active.
The compound programs are designed very
specifically for listening situations where the
focus of the user is not on a natural listening experience, but on meeting a specific need. Therefore the InterEar Speech Enhancer and InterEar
TruSound compression are not active in compound programs.
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In situations like driving a car and listening to a
backseat passenger or sitting in a wheel chair
listening to a caretaker behind the wheel chair,
hearing impaired individuals will often find it
difficult to achieve the right amount of focus.
A new listening program - the
Reverse focus program helps
solve the difficult task of listening exclusively in the reverse
direction. In this program, the
hearing aids will effectively reverse the Locator pattern
to achieve optimum focus on
sounds from behind. KEMAR
measurements done at the Widex laboratories
suggest a 5 dB improvement in the signal-tonoise ratio for sounds coming from behind. The
Reverse focus program is available both as a
normal program synchronised between the two
hearing aids and as part of a compound program with Master in the other ear.
With M-DEX, the FreeFocus option is available. This option allows
the hearing aid user to
choose between four listening directions; front,
back, right or left.
FreeFocus is not a program that can be accessed or chosen through Compass. FreeFocus
is based on the Master program and is influenced by adjustments made in this program.
The Program manager
The Program manager lets you
choose programs for the client.
The Program manager will allow
you to choose between a list
of normal programs as well as
a list of predefined compound
programs. See Fig. 27.
Fig. 27: The Program manager with normal and compound programs.
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25
The programs chosen will be displayed in the
Program starter in the Fine tuning window. Note
program 5 - a compound program with Audibility Extender in the right–ear hearing aid and
Master in the left. The Program starter panel
also displays how the different programs are
linked to the master program. See Fig. 28.
• CLEAR440 offers new programs.
• The Program manager is divided into normal programs and compound programs:
a list of pre-defined program packages.
• Using the Program starter all programs
can be specifically fine-tuned.
Fine-tuning specific programs
When activating a specific program in
the Program starter, this program can
be fine-tuned when unlinked from the
master program.
When fine-tuning a compound program, each
of the two programs is fine-tuned separately. If
fine tuning of a compound program is necessary, the program needs to be activated in the
Program starter and unlinked from the master
program. See Fig. 29 and Fig. 30.
Fig. 28: The Program starter displaying normal and compound programs.
Fig. 29: Choosing the right hearing aid with the Reverse focus program for fine tuning.
Fig. 30: Unlinking from the master program to allow fine
tuning.
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A refined Zen option
IE Zen is a refinement of our
proven Zen feature. With the
ability to exchange information
over the WidexLink, the playing
of tones in the Zen styles can
be coordinated – offering the user a stereo-like
effect when listening to Zen.
Zen is intended to be used for relaxation and
concentration purposes and experience has
shown us that Zen is well accepted as a tool that
can help end users relax and concentrate. With
CLEAR440, the user is now also offered a noise
style, introducing broadband noise as an option for situations where Zen is applied specifically for diverting attention from other disturbing sounds.
With CLEAR440, the Zen styles can be finetuned in terms of pitch, tempo and volume. It
can also be specified whether they should be
played with or without sounds from the microphones. It is also possible to define a limited
play time, meaning that the Zen styles will stop
playing after a defined period of time.
Zen can be activated as a program in the normal program stack and/or as a Zen+ option accessed with a long key press on the hearing aid
program button or RC-DEX.
When activating Zen+, the default styles are
aqua, coral and green. Experience and field
studies with Zen have shown that these are the
three styles receiving the highest rating when
judged for relaxation purposes. See Fig. 32.
Furthermore, noise can be added to the five
musical Zen styles. See Fig. 31.
Fig. 31: Zen noise chosen in
Compass.
Fig. 32: Zen+ with the three default styles and limited play time defined as 20 minutes for
Zen Aqua.
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27
Fine-tuning Zen
When changing to the Zen program using the
Program starter in the Fine tuning window, the
Zen tones will not play immediately, allowing
the hearing care professional time to talk with
his client and explain the fine-tuning options
without possible interference from the Zen
tones. The chosen Zen style is activated using the play button in the Fine tuning window.
While playing the style, it is possible to adjust
tempo, pitch and volume by entering the settings option. Under settings it can also be decided whether the microphone sound should
be on with the Zen style and, for a musical Zen
style, whether a broadband noise should also
be played. See Fig. 33.
Fine-tuning Zen step by step:
• Choose the Zen program or the Zen+
program in the Program starter.
• Talk to the client about the possible finetuning options.
• Activate a Zen style by using the play
button.
• Let the user listen to the chosen Zen
style to evaluate it.
• Fine-tune the chosen Zen style if necessary by entering Settings.
Binaural adjust can be disabled for monaural
adjustment of the left and right hearing aid. We
do not recommend disabling the binaural adjust feature when fine-tuning Zen, since it could
possibly affect the intentions of the InterEar
functionality.
Fig. 33: Activating Zen and adjusting tempo, pitch and tone volume for a style.
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Program options in CLEAR440
TYPE
PROGRAM
DESCRIPTION
Master
Best possible overall performance in all environments.
•IE TruSound compression
•HD Locator with Digital Pinna
•IE Speech Enhancer
•TruSound Softener on
•IE feedback cancelling SuperGain
Music
Optimised for reproduction of live or recorded music. Emphasises low frequencies.
•HD Locator omni
•Noise reduction off
•TruSound Softener off
•IE feedback cancelling SuperGain music
TV
Optimised for reproduction of television sound. Emphasises
high frequencies and attenuates low frequencies.
•IE feedback cancelling SuperGain max
Comfort
Optimum comfort in noisy as well as quiet environments when
speech is not essential. Higher knee point for soft sounds.
•Noise reduction comfort
•TruSound Softener Plus on
Reverse Focus
A program dedicated to focusing on sounds from behind.
•HD Locator reverse
Audibility Extender
Transposes high frequency sounds into the audible frequency
range.
•Noise reduction
•TruSound Softener off
Phone
Gives the optimum reproduction of sound during a phone
conversation
Normal - Acoustic
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29
TYPE
PROGRAM
DESCRIPTION
T
Focuses on the input from the telecoil.
MT
An acoustic program combined with input from the telecoil.
Phone+
Provides optimum intelligibility of a phone conversation by
allowing both ears access to the signal.
Zen
Randomly plays smooth and harmonic sounds to remove the
user’s focus from background noise. The sounds are distributed over two hearing aids in a binaural fitting for a stereo-like
experience.
Zen+
Program set with three individual sound styles. Randomly
plays smooth and harmonic sounds to remove the user’s focus
from background noise. The sounds are distributed over two
hearing aids in a binaural fitting for a stereo experience.
Normal - Telecoil
Audio Transmission
Sound input program
Compound
Two different programs in the two ears
T/Master
Right/left or left/right
MT/Master
Audibility Extender/
Master
Zen/Master
Reverse Focus/Master
Phone/Master
Table 1: Program options in CLEAR440.
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Chapter 4: Additional options when
fitting CLEAR440
Definable volume control
Many clients enjoy the option of a volume control to adjust the volume of the hearing aid in
specific situations. Fitting a hearing aid with a
volume control option or using a matched RCDEX allows the client the option of adjusting
volume.
Some clients adapt to the step size of the volume control very easily while others prefer different step sizes. Some users prefer fast volume
adjustment and others prefer a smaller step size
for more discrete tuning of the volume. For this
reason, CLEAR440 features the option of adjusting the volume in both larger and smaller increments. See Fig. 35.
In a default fitting, the volume can be adjusted
in 1.5 dB steps in the range of +6 dB to -12 dB.
The number of steps available depends on the
size of these.
Fig. 34: Volume bar with a default step size of 1.5 dB.
Fig. 35: The volume control step size can be changed under User Controls in the HA configuration window under Finalise.
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Additional options when fitting CLEAR440
31
Solution guide
With Compass V5 the Solution guide has
been refined and new functions implemented.
Program specific Solution guide
It is still possible to find advice about how to
adjust each program in the Program specific
Solution guide. Here you find solutions for all
programs in CLEAR440.
Undo
The Solution guide offers a ‘sequential‘
undo function, meaning that the hearing care
professional can undo the last solution he has
made.
Select topic
In the Solution guide a new category under
Identify problem has been added and the three
categories are: 1. Select topic. 2. Select category. 3. Specify complaint. See Fig. 36.
The hearing care professional follows the wizard
in the Solution Guide as usual and finds a more
detailed fine-tuning description with a client
specific solution. The Solution guide indicates
by a green check mark if a solution has been applied. Please be aware that the check mark becomes grey if you undo the solution. See Fig. 37.
Fig. 36: The three categories in the Solution Guide.
Fig. 37: In the Solution Guide you find a fine-tuning description with a client specific solution.
32 Additional options when fitting CLEAR440
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Pairing/unpairing CLEAR440
hearing aids
It is well known that a binaural fitting of hearing aids is the best way to target the difficulties
faced with a binaural hearing loss. With the new
InterEar features in CLEAR440, fitting two hearing aids, when possible, will offer the client even
more features to help overcome his daily challenges.
When fitting a pair of CLEAR440 hearing aids,
the aids are paired in a number of ways allowing for best possible use of and benefit from the
InterEar functionalities offered. The default fitting allows the synchronisation of program and
volume control as well as InterEar functionalities
in noise reduction, compression and feedback
cancelling.
Unpairing CLEAR440
In some situations though, a hearing aid user
may decide not to continue with the binaural
solution, for example because of inability to acclimatise to the binaural fitting, the cost of buying two hearing aids or lack of acceptance of
wearing two hearing aids. Also some users
prefer to have two hearing aids, but only
wear them one at a time.
When such a client returns to the hearing care
professional, the professional can decide to go
online with just one of the aids to make further
adjustments while leaving the other aid unadjusted or maybe returned to the clinic.
Compass ensures that the hearing care professional is prompted on the decisions necessary
to make online adjustments to one hearing aid
belonging to a pair. See Fig. 38.
The hearing care professional may decide to use
hearing aid data, which allows him to keep all
original data from the first fitting, i.e. programs,
fine tuning etc. In the case of using Compass
data, a new fitting is started based on a monaural rationale. See Fig. 39.
Continuing the monaural fitting will prompt the
hearing care professional that the InterEar functionalities will no longer be active in the fitting.
If the two hearing aids are connected simultaneously again later, Compass will automatically
reestablish the pairing.
Fig. 38: Dialogue when online with one hearing aid of an original
pair.
Fig. 39: The hearing care professional is advised that the hearing
aid is one of a pair and that continuing will mean that all syncronisation between the aids will be switched off.
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33
Pairing CLEAR440
In situations where a client has had a pair of
hearing aids unpaired or have only been fitted
monaurally from the beginning, going online
with two CLEAR440 hearing aids simultaneously will allow the hearing care professional to
choose whether to use hearing aid data or Compass data. See Fig. 40.
To continue a fitting based on hearing aid data,
the data in the two hearing aids must match so
that relevant features can be synchronised and
coordinated. Compass informs the hearing care
professional of the points where the two hearing aids do not match and prompts him to make
a decision on which settings to use. See Fig. 41
and Fig. 42.
Fig. 40: Choosing either hearing aid data or Compass data for the continued fitting.
Fig. 41: The volume step size differs in the two hearing aids. The hearing
care professional can choose which step size to use.
Fig. 42: The program settings differ in the two hearing aids. A
choice of using either left or right settings is given.
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Service Reminder
The Service Reminder is a message played in
the user’s hearing aid to remind him about making a new appointment at the hearing care professional. The Service Reminder is an optional
function activated in Compass. See Fig.43.
Please be aware that Compass automatically resets the Service Reminder when connecting a
hearing aid. The hearing care professional has
to activate the Service Reminder each time during a visit to ensure the right time interval till
the next visit.
In the drop-down menu it is possible to choose
a time interval for when the Service Reminder
should be played. When the hearing care professional chooses a time interval, a dialogue box
appears. See Fig. 44.
Fig. 43: The Service Reminder function is activated in Compass under Finalise and HA configuration.
Fig. 44: This dialogue box appears when the hearing care professional chooses
a time interval.
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35
Safety code
Some hearing care professionals have asked for
a Safety code to ensure that data from a fitted
hearing aid is not accessible to others.
The Safety code ensures that if the hearing aid
is connected to another fitting system, a code
must be entered. Otherwise, it is not possible to
open the fitting and work with the hearing aid
data. See Fig. 45.
The code automatically expires when the expiration date defined is reached. After this date,
no code is necessary to fit or fine-tune the hearing aid.
Fig. 45: The Safety code panel is, by default, closed when you open the Close window. You can open the panel and use it
to define a safety code for the hearing aid.
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Chapter 5: Rationale changes
affecting the fitting
AISA III
Efforts are constantly made to ensure that AISA
provides the most accurate picture of the in-situ
acoustics possible in every situation. The possibilities offered by AISA in terms of ensuring
precise gain prescription will be explored to the
widest possible extent in CLEAR440 for even
further precision in fitting.
Sound Harmony in Flex Fittings
AISA III now also offers Sound Harmony for flex
(i.e., ventilated) fittings in CLEAR440.
Originally introduced in connection with open
fittings, Sound Harmony minimises uncertainties with respect to how much gain is given.
With a completely closed earmould, there is
no vent through which external sound can leak
in. This is not the case with ventilated fittings,
however. With a flex fitting there will always be
a certain amount of directly transmitted sound
leaking in through the vent.
These uncertainties are handled by means of
Sound Harmony. Sound Harmony makes sure
that gain application is always under control
by making bands transparent when the directly transmitted sound and the hearing aid sound
are on competing levels.
Band transparency in flex fittings
In open fittings, the three lowest bands (125,
250, 350 Hz) are made transparent by default
by the system. In flex fittings, on the other hand,
the three lowest bands may be made transparent by the system if specified by the rationale,
but they are not transparent by default. See Fig.
46.
Minor adjustments in rationale
A few minor adjustments have been made in
the rationale in connection with CLEAR440. In
practical terms, this may lead to fewer instances of band transparency and slightly different
Insertion Gain values for open fittings than you
would see with, for instance, a mind440 hearing aid.
If the directly transmitted sound is more or less
equal in level with the hearing aid sound at low
frequencies, this may lead to uncertainties with
respect to how much gain is actually applied at
the eardrum.
HTL: 60, 60, 60, 60. Vent diameter: 1.0 mm
HTL: 30, 50, 70, 70. Vent diameter: 1.7 mm
Fig. 46: Band transparency varies with hearing loss configuration and vent diameter. We can see that only the lowest
band is transparent in the left panel (flat hearing loss, 1 mm vent) while two bands are transparent in the right panel
(sloping hearing loss, 1.7 mm vent).
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Rationale changes affecting the fitting
37

Fitting CLEAR440

Transcription

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